| 王月香,唐杰,安力春,林倩,李俊来,徐建宏.超声造影引导微波凝固治疗Ⅰ～ Ⅲ级肝外伤的实验研究[J].中国医学影像技术,2006,22(2):173~176 |
| 超声造影引导微波凝固治疗Ⅰ～ Ⅲ级肝外伤的实验研究 |
| Contrast-enhanced ultrasound-guided microwave tissue coagulation therapyfor hepatic trauma of grade Ⅰto Ⅲ: experimental study |
| 投稿时间：2005-12-12 修订日期：2006-01-25 |
| DOI： |
| 中文关键词: 肝 创伤 微波 超声检查 造影剂 |
| 英文关键词:Liver Trauma Microwave Ult rasonography Cont rast media |
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| 中文摘要: |
| 目的 探讨超声造影引导微波凝固治疗Ⅰ～ Ⅲ级肝外伤伴活动性出血的应用价值。方法 全麻开腹状态下10只肝素化小型猪共建立Ⅰ～ Ⅲ级肝外伤伴活动性出血模型40 处,超声造影引导下将微波电极植入肝内活动性出血部位进行微波凝固治疗。治疗后2 h 观察治疗区有无再出血和血肿,并行超声造影检查及组织病理学检查判断疗效。结果 40处肝外伤伴活动性出血微波治疗后均成功控制出血, Ⅱ级和Ⅲ级肝外伤局部出血时间[ (192. 0 ±108. 0) s 和(443. 4 ±63. 5)s ]均长于Ⅰ级肝外伤[ (48. 3 ±33. 3) s ] ( P < 0. 01) ,出血量[ (24. 8 ±6. 5) g 和(47. 8 ±10. 5) g ]均大于Ⅰ级肝外伤[ (6. 6 ±4. 3) g ] ( P < 0. 01) 。微波治疗后2 小时局部肝被膜均未见活动性出血和血肿。灰阶超声造影显示9 处Ⅱ级和5 处Ⅲ级肝外伤治疗区仅周边部见少许走行规则的线状增强,余治疗区均未见增强,呈负性显影。组织病理学显示, Ⅰ～ Ⅲ级肝外伤微波治疗区内肝细胞变性明显,肝小叶内见多个大小不等的腔隙;血管壁的退变以近针道区明显,而远离针道区变化不明显。结论 超声造影引导微波凝固治疗对Ⅰ～ Ⅲ级肝外伤伴活动性出血较好的治疗作用,有望成为临床上外科治疗的一种重要辅助方法。 |
| 英文摘要: |
| Objective To study the value of cont rast-enhanced ultrasound-guided microwave tissue coagulation (MTC)therapy for hepatic t rauma of grade Ⅰto Ⅲ. Methods Hepatic t rauma of grade Ⅰ, Ⅱand Ⅲwith active hemorrhage werecreated respectively in 10 heparinized porcine livers. MTC was performed under the guidance of cont rast-enhanced ult ra-sound. Two hours af ter MTC , the therapeutic region was observed again and cont rast-enhanced ultrasound and pathologicexamination were performed to assess the effect of MTC. Results All hepatic t rauma were t reated successfully with MTC.The bleeding time in t raumatic regions of grade Ⅱand Ⅲ ( [192. 0 ±108. 0 ] s , [ 443. 4 ±63. 5 ] s) were longer than that ingrade Ⅰ ( [48. 3 ±33. 3 ] s) ( P < 0. 01) and the blood loss ( [24. 8 ±6. 5 ] g and [47. 8 ±10. 5 ] g) were also larger than that ingrade Ⅰ ( [6. 6 ±4. 3 ] g) (P < 0. 01) . Two hours af ter MTC no hemorrhage and hematoma was observed on the surface oftherapeutic region. Cont rast-enhanced ultrasound showed that the therapeutic region was not enhanced in spite of a few smallregular vascular enhancement at the periphery in 9 t rauma of grade Ⅱand 5 t rauma of grade Ⅲ. Pathologic examinationshowed the hepatocytes were degenerative obviously in all therapeutic region but vessels were degenerative only in the cent ralarea. Conclusion MTC therapy is effective in t reating hepatic t rauma of grade Ⅰto Ⅲwhich may be an auxiliary method tosurgery. |
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